Provider Demographics
NPI:1063655439
Name:KINNARD, LUKE THOMAS (DPT)
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:THOMAS
Last Name:KINNARD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 VERRET ST
Mailing Address - Street 2:
Mailing Address - City:HOUMA
Mailing Address - State:LA
Mailing Address - Zip Code:70360-4637
Mailing Address - Country:US
Mailing Address - Phone:985-868-3806
Mailing Address - Fax:985-868-3805
Practice Address - Street 1:901 VERRET ST
Practice Address - Street 2:
Practice Address - City:HOUMA
Practice Address - State:LA
Practice Address - Zip Code:70360-4637
Practice Address - Country:US
Practice Address - Phone:985-868-3806
Practice Address - Fax:985-868-3805
Is Sole Proprietor?:No
Enumeration Date:2009-04-14
Last Update Date:2009-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA07284225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist